Understanding Addison's Disease -- Diagnosis & Treatment

How Is Addison's Disease Diagnosed?

Before starting treatment, a doctor has to be sure a person has Addison's disease. In its early stages, Addison's disease can be difficult to diagnose. Often, it's first detected through routine tests done in a hospital or doctor's office. But the most definitive way to diagnose the condition is to measure hormone levels in the blood and urine before and after giving ACTH. ACTH is a hormone that, when activated, normally increases the amount of cortisol being produced by the adrenal gland.

X-rays, CT scans, and a tuberculosis skin test may also be used to help pinpoint the cause.

What Are the Treatments for Addison's Disease?

Since Addison's disease is basically a lack of normal hormones, it can be treated by replacing those hormones. This can be done with once- or twice-daily tablets of hydrocortisone, a steroid hormone. If needed, aldosterone can be replaced with a synthetic form (called Florinef or fludrocortisone acetate), which is taken once a day by mouth. These medications need to be increased during times of stress, infection, surgery, or injury.

Treatment is almost always completely successful. When treated, people with Addison's disease can lead a full and normal life. It is, however, important to carry a medic alert bracelet and card at all times as well as keeping a small supply of medications at work or school. Even missing one dose can be dangerous.

In patients suspected of having an Addisonian crisis, doctor-prescribed injections of salt, fluids, and glucocorticoid hormones may be given immediately -- even before a diagnosis of Addison's disease is confirmed.